Evidence map›Paper›PMID 31891138›Full record

ArticleEClinicalMedicine2019

Association between HIV infection and outcomes of care among medicare enrollees with breast cancer.

Sumedha Chhatre, Marilyn Schapira, David S Metzger, Ravishankar Jayadevappa

Open access · goldAbstract read
In one paragraph

Article in EClinicalMedicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Sumedha ChhatreDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
Marilyn SchapiraDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
David S MetzgerDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
Ravishankar JayadevappaDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
University of Pennsylvania · USPhiladelphia VA Medical Center · US

Funding

Virus & Reservoirs CoreP30AI045008 · NIAID · UNIVERSITY OF PENNSYLVANIA · PI DAVID S METZGER · 1999 to 2026
$78.6M
Penn Mental Health AIDS Research CenterP30MH097488 · NIMH · UNIVERSITY OF PENNSYLVANIA · PI Karine Dube · 2013 to 2026
$23.5M
Cancer Care among Medicare HIV patientsR21AG034870 · NIA · UNIVERSITY OF PENNSYLVANIA · PI CHHATRE, SUMEDHA · 2010 to 2011
$257k
NIAID NIH HHS P30 AI045008NIA NIH HHS R21 AG034870NIMH NIH HHS P30 MH097488
6 · The paper itself

Abstract

backgroundTo assess the interaction of breast cancer, HIV infection, Medicare disability status, cancer stage and its implications for outcomes, after accounting for competing risks among female, fee-for-service Medicare enrollees.

methodsWe used data from Surveillance, Epidemiology and End Results (SEER) -Medicare (2000-2013). From primary female breast cancer cases diagnosed between 2001 and 2011, we identified those with HIV infection. We used Generalized Linear Model for phase-specific incremental cost of HIV, Cox regression for association between HIV and all-cause mortality, and Fine and Gray competing risk models to assess hazard of breast cancer-specific mortality by HIV status. We also studied this association for subgroups of cancer stage and disability status.

findingsOf 164,080 eligible cases of breast cancer, 176 had HIV infection. Compared to HIV-uninfected patients, HIV infected patients had 16% higher cost in initial phase, and 80% higher cost in interim stage of care, and at least two times higher mortality (all-cause and breast cancer-specific), after accounting for competing risk. Among disabled enrollees, HIV-infected patients had higher risk of all-cause and breast cancer-specific mortality, compared to HIV-uninfected patients.

interpretationFemale fee-for-service Medicare enrollees with breast cancer experience higher initial and interim phase cost and worse survival in the presence of HIV. This association was also significant among disabled Medicare enrollees. Medicare is the single largest source of federal financing for HIV care. Burden on Medicare will grow exponentially due to higher proportion of disabled among HIV-infected enrollees, longer survival among HIV- infected persons, increased HIV incidence in older adults, and increased age related risk of breast cancer. Future research can identify the pathways via which HIV infection affects cost and mortality, and develop integrated strategies for effective management of concomitant breast cancer and HIV and inform survivorship guidelines.

fundingNational Institute on Aging, National Institutes of Health, Grant # R21AG34870-1A1.

Indexed as

Breast cancerCompeting riskDisabledHIVMedicareMortalityPhase-specific cost of care

Identifiers

PMID31891138
PMCPMC6933147
OpenAlexW2989967137

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.